One of the major advances of present-day society is in the field of computerized telecommunications. Today, in the growing field of behavioral medicine, formal verbal interchange is essential to provide modification of behavior and reinforcement. By using computerized telecommunications coupled with voice recognition technology, a client's behavior can be modified and reinforced at the site where behavior occurs and wherever the client goes. It has been found that as the frequency of reinforcing feedback increases, the client shows more rapid progress towards a particular goal. By utilizing a system of continuous computerized reinforcement, a client can be provided with more opportunity and greater frequency of therapeutic contact or feedback than through treatment in person. Additionally, the use of an interactive system vastly increases the therapeutic effect of this method of behavioral modification and reinforcement.
Learning is enhanced through interactive feedback, and feedback in some form heightens the learning experience. The number of times in school a teacher asks any one child for an answer is fairly limited. Most of the time, children raise their hands and respond, and get back a "right" or "wrong." If they are wrong, they have lost their chance, and someone else is called upon for the answer. In traditional adult education and behavioral modification, the amount of continuing feedback is limited to the time actually spent with a counselor or in a seminar. Here, too, the feedback is limited to the actual time the counselor or trainer spends providing interaction with any one client. By contrast, the addition of a computer and telecommunications or broadcast transmission allows "narrowcast" interaction and feedback on a continuous 24-hour basis to the client wherever he goes, allowing for far greater frequency of interaction. Most importantly, in the case of adult behavior modification, this feedback becomes available for the first time at the site where the behavior occurs.
Learning by playing and doing is fundamental to all mammals. While audio broadcast or telecommunications are media based upon hearing, and video broadcast is a medium based upon seeing, interactive feedback utilizing these architectures is a medium based upon doing or responding to the stimulus of feedback. Recent studies have revealed that the single best way to increase mammalian intelligence is through interactive stimulation. The frequency of feedback that we receive generally is the single greatest factor affecting learning and modifying behavior. Further, learning by receiving immediate feedback is preferable to receiving a delayed response. Children prefer interactive television games to merely watching a television program. They become impatient with long strings of dialogue, and the focus of their attention is diverted by devices providing rapid feedback. Adults display the same behavior throughout their lives. For example, when purchasing an appliance, they rarely read the instructions before trying to use it. The need to receive continuing feedback, at all levels of life, is a human characteristic, thus providing a basic survival mechanism which fosters learning and continuing growth.
Research indicates that learning is enhanced by interactive feedback. Where the quantity of interactive feedback is increased, focus is sustained or increased, thereby stimulating keen responsiveness, as is the case with video games. The active involvement required to respond by answering provocative questions stimulates conscious awareness of and focus on the issue at hand. Learning and behavioral modification systems that incorporate rapid feedback foster problem-solving abilities, pattern recognition, management and allocation of resources, logical thinking patterns, memory, quick thinking, and reasoned judgment. Most importantly, when these skills are practiced at the site where the desired behavior is to occur, learning is more vivid and is quickly integrated into real life.
A sense of control is perceived with the provision of feedback. By engaging the client to direct his focus and asking provoking questions, involvement is increased and stimulation results. When the individual learner achieves success and immediately receives positive feedback, self-esteem is rapidly built. When success is rewarded, confidence and resilience are enhanced and knowledge is created.
Historically, individuals have sought self-improvement through self-help books, seminar workshops and programs of aperiodic or short duration. With the best of intentions relapse usually occurs within several days after reading a book or attending a seminar, or several months after the conclusion of a behavioral modification program.
In contrast, computer-derived, self-adjusting motivational guidance, which interactively polls the client and comments on his performance as he goes about his daily life throughout the year, has a more lasting effect. It differs importantly from seminars and visits to counselors in that it modifies behavior at the site where the behavior occurs, with personal or customized intervention. The more frequent interactive dialogue between the counselor-controlled computer and the client enhances the feedback and therapeutic simulation in much the same way as has been experienced in other interactive communication structures, such as education and entertainment. For instance, consumers accord a higher value to interactive entertainment software than to passive software, due to the greater stimulation afforded by this mode. In entertainment software, an example would be some of the new video games that present a mode which runs like an animated cartoon until one elects to interact. As an animated cartoon, the video usually becomes boring within minutes. But as an interactive video game, the software stimulates the user with hours of entertainment.
Furthermore, interactive text based online services now enable people using personal computers or other access devices to interact with other people using telephone line connections channeled through a central host computer. Since the early 1980's, the range of services and the number of people using online services have grown significantly. In addition, increased exposure to computers in the workplace and at school has resulted in growing use of computers in the home.
Also, technology advances have reduced the size of personal computers and have led to an increasing range of mobile personal computers, including laptops, notebooks and pocket computers and other electronic devices such as the Personal Digital Assistants (PDA's) and Personal Communicators. Increasingly, these devices incorporate telecommunication capabilities which enable them to access online services at work, at home or while traveling.
The effectiveness of both the telephone and the computer and online services has been shown to dramatically affect behavior due to their potential to give an increased dose of reinforcement on a continuing basis in the environment where the behavior occurs. As software and hardware platforms advance in sophistication, the opportunity will grow dramatically to further create realistic and engaging motivational support and guidance.
Therefore a need exists for a computer-driven interactive two-way communication link that increases the opportunity to create realistic and engaging behavioral reinforcement and guidance in the home or office and at remote locations with both stationary and portable wired and wireless communication devices.
Furthermore, psychotherapy outcome studies have been aimed at understanding how people change their behavior with and without the use of psychotherapy counseling. The results of these outcome studies have produced a definitive structure or model of the process of change that underlies both self-initiated and therapy-assisted modification of human behavior.
More particularly, the structure or process of behavioral change has been defined into six separate and distinct stages which have been observed by researchers. These distinct stages are variously known as precontemplation, contemplation, preparation, action, maintenance and relapse. Relapse can occur at anytime. It represents the failure of the individual to sustain the new behavior.
In surveying the individual or core fundamental therapeutic techniques utilized variously in 300 to 400 forms of counseling and self initiated help by individuals, researchers have derived 14 fundamental processes for moving a person from one behavioral stage to another. These individual processes are now seen to be operant mechanisms for personal growth and transformation. In the past almost all intervention programs for both physical health and mental health behavior problems have been based upon individual theories posited about how individuals proceed through therapeutic transformation. Now, with the recent abstraction and derivation of these 14 fundamental processes, it is possible to direct the construction of the content of therapeutic interventions according to a successfully derived model or format. While the greatest amount of research in this area of refining and applying these 14 processes has been initially in the field of smoking cessation, subsequent research has indicated the universal applicability of these processes across a wide range of human learning and behavior.
In the past, these individual processes have been administered ad hoc or randomly by various counselors in verbal change processes in person or through various methods including but not limited to bibliotherapy, (reading motivational literature) direct telephone counseling, group therapy classes and seminars. Furthermore, it must be remembered that outpatients on the average spend about 99% of their waking weeks outside of the therapy situation. There are advantages to having therapy and behavioral guidance parallel self-change efforts that clients make outside of therapy into their daily lives. The disadvantages of the prior art are overcome by the present invention which provides a more comprehensive approach while affording greater convenience and increased interactive contract for physicians, psychotherapists and various counselors.
Therefore, a need exists to apply and distribute these 14 processes individually and collectively through the medium of computerized telecommunication. More particularly, this need is magnified due to the large number of variables and combinations in timing the administration of the 14 processes within the 6 stages of the change process on an individualized basis. The computerized administration and transmission of these individual processes both separately and collectively is a novel and unique advancement not known in the art.
In summary, a computerized interactive system increases the client's ability to resolve problems at the site where behavior occurs, and adjusts him within the framework of a preset goal. By including, within the context of the personalized message, challenges in the form of questions, an entertaining and stimulating process can be added due to the increased feedback or interactive nature of new telecommunication technology.
With regard to the prior art, many types of systems have endeavored to provide an effective means for providing surveillance over the behavioral modification of a patient or client by using a telecommunication link. However, these prior art systems have not disclosed an adequate and cost-effective telecommunication network that uses a computer in combination with a telephone or other platforms to provide positive motivational messages and/or questions that are answered by a client by means of a dual tone multifrequency telephone set or other platforms.
Further, the prior art systems have not disclosed utilization with such hardware as voice stress analyzers, on line services, olfactory units, CD-ROM platforms, interactive television in connection with a telecommunication link as a further behavioral modification means in use with the client.
A search of the prior art discloses patents that show different types of feedback mechanisms:
______________________________________ PATENT NO. INVENTOR ISSUED ______________________________________ 3,742,938 T. J. Stern 03 July 1973 3,808,694 W. Y. Hutchinson et al. 07 May 1974 4,112,425 G. J. Zobrist et al. 05 Sep. 1978 4,237,344 J. R. Moore 02 Dec. 1980 4,328,494 R. Goodall 04 May 1982 4,377,214 G. G. Hansen et al. 22 Mar. 1983 4,396,976 G. P. Hyatt 02 Aug. 1983 4,602,127 J. F. Neely et al. 22 July 1986 4,773,492 E. Ruzumna 27 Sep. 1988 4,831,242 W. H. Englehardt et al. 16 May 1989 4,835,372 Gombrich et al. 30 May 1989 4,916,435 K. L. Fuller 10 Apr. 1990 4,922,514 Bergeron et al. 01 May 1990 4,912,552 Allison III et al. 27 Mar. 1990 4,933,873 S. B. Kaufman et al. 12 June 1990 4,952,928 G. T. Carroll et al. 28 Aug. 1990 5,008,835 E. F. Jachmann et al. 16 Apr. 1991 5,014,298 R. A. Katz 07 May 1991 5,018,736 T. R. Pearson et al. 28 May 1991 5,023,901 P. Sloan et al. 11 June 1991 5,036,462 S. B. Kaufman et al. 30 July 1991 5,038,800 K. Oba 13 Aug. 1991 5,068,080 A. J. Impink Jr. et al. 26 Nov. 1991 5,085,527 P. A. Gilbert 04 Feb. 1992 5,126,957 S. B. Kaufman, et al. 30 June 1992 5,127,003 W. J. Doll, Jr. et al. 30 June 1992 5,142,484 S. B. Kaufman, et al. 25 Aug. 1992 5,170,426 F. D. D'Alessio, et al. 08 Dec. 1992 5,189,395 M. S. Mitchell 23 Feb. 1993 5,206,897 N. Goudreau, et al. 27 Apr. 1993 5,218,344 J. G. Ricketts 08 June 1993 5,219,322 L. R. Weathers 15 June 1993 5,224,173 R. J. Kuhns, et al. 29 June 1993 5,245,656 S. K. Loeb, et al. 14 Sep. 1993 ______________________________________
The Sloan et al., patent discloses a surveillance system which integrates voice identification with passive monitoring mechanisms. The system comprises a central station located at a supervisory authority and a plurality of remote voice verification units. Each unit is located at a designated locality for an individual under surveillance and is connected to the central station via telephone lines. The central station consists of a control computer system and a violation computer system. The central station maintains and analyzes all relevant data for each individual, and initializes and retrieves information from each voice verification unit. Each voice verification unit conducts a voice verification test of a respective individual according to test schedules outlined by the central station. Test and monitoring results obtained during a defined surveillance period are transmitted to the central station on a periodic or exigent basis. Each remote station has a modem input, test means input connected to a microphone, and a third input to receive passive monitoring signals. The active and passive signals are analyzed according to an algorithm and command signals received from the central station. The test means also has an output to prod the individual to speak a preselected series of words. The test schedule in each remote is randomly created for each period and individual.
The Fuller patent discloses a remote confinement monitoring station and system with a central office that provides means for automatic selection of a specific confinee. The central office selects scheduled or semi-random monitoring calls, to avoid a high degree of predictability by the confinee, auto dialing means for transmission of a prerecorded or synthesized audio instruction message to the confinee, and recording of information received in response to the acts of the selected confinee preformed in response to the communicated message. The central office has a computer with a telephone line modem, a voice synthesizer, and other accessories in displays for automatic recording of data received including a visual camera image and breath analyzer results, and can include automatic image comparison and violation signal alarming.
The Moore patent discloses a rapid response hospital health care communications system. The system includes an auto dialer telephone system to allow patients to communicate from outside the hospital to receive advice and health care as indicated by the patient's medical profile. The communications system includes a health care console with an information storing computer connected through various communication paths to in-hospital patients, and by telephone means to out-of-hospital patient locations. Each out-of-hospital location includes a communication interface with a telephone, a console, and a hand-held remote control comprising a plurality of sensors, indicators and features. The interface includes an auto dialer and auto identifier that dials the health care console and identifies the patient by a computer recognizable code.
The Kaufman et al., patent discloses an interactive patient assisting device that has both preselected doses of medicine and a physical testing device that can communicate with a remote medical center over the telephone system. The system includes a clock/calendar unit that can be programmed to establish a schedule of a variety of activities, a pharmaceutical dispenser, a voice synthesizer and recognitions unit, a computer, displays, and monitor means for blood pressure, oxygen and temperature. For communicating to a remote location, an automatic dialer, modem and telephone are included.
The Bergeron et al., patent discloses a method and system for the dispatch of resources to remote sites in response to alarm signals. A processor accesses the database of, for instance, a field service engineer designated to provide services to particular remote sites in response to the alarm signals received from those sites. The processor then attempts to establish a telephone connection with the field service engineer and provide the engineer with information by means of synthesized voice messages. The system may execute remote diagnostic programs and determine the results and attempt to communicate with selected resources. The system has a conventional processor with a database, voice synthesizer, voice system and auto dialer. When the system dials and the telephone is answered, the system requests an identification code by means of the touchtone buttons before it communicates.
The Hutchinson patent discloses a weighing and height measuring device. It is especially adapted for use with a remote digital read-out system. The device comprises a weight responsive moving platform connected by cable to a remote digital read-out unit. One of the objects of the invention is to provide a weight measuring device adapted for use with a remote read-out and/or computer input device.
The Stern patent discloses a cardiac pacer and heart pulse monitor for remote diagnosis wherein information from a pair of sensors is transmitted by means of a telephone handset and transmitter, over a commercial telephone system to a remote receiver. Information received at the receiver may then be processed by means of an appropriate computer and program system.
The Carroll patent discloses an adaptable electronic monitoring system. The system is configured to fit the needs of a particular monitoring or identification application by selecting appropriate modules. The system provides for monitoring at a central location and communication between the location of the sensed information to the processing site by means of a normal telephone communications system.
The Doll patent discloses a digital/audio interactive communications network. The digital network may be a wide area, metropolitan or local area network, and may communicate with other networks. The digital network ties a digital LAN server and an audio server together. The system works with software directed to a client/server architecture in an application that requires recording and playback of audio information.
The D'Alessio patent discloses a method and system for home incarceration using a telephone network and voice verification. The system has a control center with a process server connected to controllers through a LAN such as an ethernet or wide area network. New inmates are added by voice training so that the system can create voice templates of selected words. A data base of the voice templates and phone numbers, work schedules, etc. is created. Calls received are screened by using caller ID. Calls to and from the inmate are performed on a predetermined or random frequency, the frequency being a function of the patient's behavior. All activities are maintained in a log file.
The Ricketts patent discloses a method and system for monitoring personnel using computers and transceivers and a network. The interactive system monitors the identity and location of the inmates of a correctional facility, hospital, school or the like, and can alert the inmate that the inmate is entering a restricted area, or being approached by another inmate within a predetermined threshold distance. The inmate's transceiver can include a bar code for use of vending machines, telephone and the like, with the transactions being allowed or denied by the computer.
The Weathers patent discloses a psychotherapy apparatus and method for treating undesirable emotional arousal of a patient. The system presents visual and audio stimuli in each ear and eye separately and synchronously and alternately, the presentation being controlled in response to the patient's physiological responses to the stimuli. In addition to the behavior modification stimuli supplied to the patient by the computer, an operator, using a microphone, can direct the patient's attention.
The other cited patents are for background purposes and are indicative of the art to which the invention relates.
It will be noted that the above mechanisms and systems do not allow the utilization of various well known elements used in a unique random calling manner with a client database and client program of prescribed messages and/or questions for particular persons. More particularly, the instant apparatus and method provides a uniquely reinforcing approach of allowing the use of prescribed messages and/or questions for particular persons. More particularly, the instant apparatus and method provides a uniquely reinforcing approach of allowing the use of random calls at random locations from a list of possible locations where a client may be located. Furthermore, this system utilizes existing telecommunication technology including pagers, online services, etc., unlike many of the devices described in the above referenced patents.